Elevated Interleukin-6 Levels Are Associated With an Increased Risk of QTc Interval Prolongation in a Large Cohort of US Veterans

被引:4
|
作者
Lazzerini, Pietro Enea [1 ]
Cupelli, Michael [2 ,3 ]
Cartocci, Alessandra [4 ]
Bertolozzi, Iacopo [5 ]
Salvini, Viola [1 ]
Accioli, Riccardo [1 ]
Salvadori, Fabio [1 ]
Marzotti, Tommaso [1 ]
Verrengia, Decoroso [1 ]
Cevenini, Gabriele [4 ]
Bisogno, Stefania [1 ]
Bicchi, Maurizio [1 ]
Donati, Giovanni [1 ]
Bernardini, Sciaila [1 ]
Laghi-Pasini, Franco [1 ]
Acampa, Maurizio [1 ]
Capecchi, Pier Leopoldo [1 ]
El-Sherif, Nabil [2 ,3 ]
Boutjdir, Mohamed [2 ,3 ,6 ]
机构
[1] Univ Siena, Dept Med Sci Surg & Neurosci, Siena, Italy
[2] VA New York Harbor Healthcare Syst, New York, NY USA
[3] Suny Downstate Med Ctr, Hlth Sci Univ, New York, NY USA
[4] Univ Siena, Dept Med Biotechnol, Siena, Italy
[5] Nuovo Osped San Giovanni di Dio, Cardiol Intens Therapy Unit, Dept Internal Med, Florence, Italy
[6] NYU, Grossman Sch Med, New York, NY USA
来源
关键词
arrhythmic risk; general population; IL-6; QTc prolongation; LEUKEMIA INHIBITORY FACTOR; C-REACTIVE PROTEIN; MIDDLE-AGED MEN; INFLAMMATION; PREVENTION; TRANSIENT; DEATH;
D O I
10.1161/JAHA.123.032071
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Although accumulating data indicate that IL-6 (interleukin-6) can promote heart rate-corrected QT interval (QTc) prolongation via direct and indirect effects on cardiac electrophysiology, current evidence comes from basic investigations and small clinical studies only. Therefore, IL-6 is still largely ignored in the clinical management of long-QT syndrome and related arrhythmias. The aim of this study was to estimate the risk of QTc prolongation associated with elevated IL-6 levels in a large population of unselected subjects. METHODS AND RESULTS: An observational study using the Veterans Affairs Informatics and Computing Infrastructure was performed. Participants were US veterans who had an ECG and were tested for IL-6. Descriptive statistics and univariate and multivariate regression analyses were performed to study the relationship between IL-6 and QTc prolongation risk. Study population comprised 1085 individuals, 306 showing normal (<5pg/mL), 376 moderately high (5-25 pg/mL), and 403 high (>25pg/mL) IL-6 levels. Subjects with elevated IL-6 showed a concentration-dependent increase in the prevalence of QTc prolongation, and those presenting with QTc prolongation exhibited higher circulating IL-6 levels. Stepwise multivariate regression analyses demonstrated that increased IL-6 level was significantly associated with a risk of QTc prolongation up to 2 times the odds of the reference category of QTc (e.g. QTc >470 ms men/480 ms women ms: odds ratio, 2.28 [95% CI, 1.12-4.50] for IL-6 >25 pg/mL) regardless of the underlying cause. Specifically, the mean QTc increase observed in the presence of elevated IL-6 was quantitatively comparable (IL-6 >25 pg/mL:+6.7 ms) to that of major recognized QT-prolonging risk factors, such as hypokalemia and history of myocardial infarction. CONCLUSIONS: Our data provide evidence that a high circulating IL-6 level is a robust risk factor for QTc prolongation in a large cohort of US veterans, supporting a potentially important arrhythmogenic role for this cytokine in the general population.
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页数:14
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